PRACTICE IMMERSION CLINICAL EVALUATION TOOL – AGENCY/SITE

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Practice Immersion Clinical Evaluation Tool – Agency/Site

Practice Immersion Clinical Evaluation Tool – Agency/Site
 
Practice Immersion Clinical Evaluation Tool – Agency/Site
Agency/Site Criteria
Student Evaluation
 
Faculty Evaluation
Comments
Does Not Meet
Meets
Excels*
Does Not Meet
Meets
Excels*
1.       Agency/site was able to provide the opportunities for the student to meet practice immersion clinical objectives.
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2.       Agency/site was able to establish a comfortable, yet stimulating, practice environment.
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Criteria:
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Does Not Meet:  Elements are missing.
Meets:  Agency/site meets this criterion.
Excels:  Agency/site meets this criterion and further a teaching point opportunity or expanded information, guidance, or other element to further enhance student learning.
Agency/site – strengths:
Student Evaluation
Faculty Evaluation
Agency/site – areas of improvement needed:
Student Evaluation
Faculty Evaluation
 
Agency/site – Suggestions to incorporate more responsiveness to student learning needs:
Student Evaluation
Faculty Evaluation
 
Practice Immersion Clinical Evaluation Tool – Mentor
Clinical Criteria
Student Feedback of Mentor Experience
Comments
Does Not Meet
Meets
Excels*
3.       Exemplify professionalism in diverse health care settings.
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4.       Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.
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5.       Implement patient care decisions based on evidence-based practice.
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6.       Utilize patient care technology and information management systems.
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7.       Communicate therapeutically with patients.
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8.       Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.
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9.       Understand the human experience across the health-illness continuum.
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10.    Provide culturally sensitive care.
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11.    Preserve the integrity and human dignity in the care of all patients.
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Criteria:
Does Not Meet:  Elements are missing; mentor did not achieve.
Meets:  Mentor meets this criterion.
Excels:  Mentor meets this criterion and further incorporates a teaching point scenario or expanded information, guidance, or other element to further enhance student learning.
Practice Immersion Clinical Evaluation Tool – Student
Clinical Criteria
Mentor
Sign Off
Faculty Sign Off
Comments
Does Not Meet
Meets
Excels*
12.    Exemplify professionalism in diverse health care settings.
☐
☐
☐
☐
13.    Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.
☐
☐
☐
☐
14.    Implement patient care decisions based on evidence-based practice.
☐
☐
☐
☐
15.    Utilize patient care technology and information management systems.
☐
☐
☐
☐
16.    Communicate therapeutically with patients.
☐
☐
☐
☐
17.    Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.
☐
☐
☐
☐
18.    Understand the human experience across the health-illness continuum.
☐
☐
☐
☐
19.    Provide culturally sensitive care.
☐
☐
☐
☐
20.    Preserve the integrity and human dignity in the care of all patients.
☐
☒
☐
☐
Criteria:
Does Not Meet:  Elements are missing; student is required to remediate this element to pass the course
Meets:  Student meets this criterion.
Excels:  Student meets this criterion and further incorporates a teaching point scenario
 

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